Process improvement of facility based newborn care in India

The largest absolute number of newborn deaths occurs in South Asia - India contributes a quarter of the world total. Hence, the Government of India has recognized that the reduction of neonatal mortality is essential for making an impact on the Infant Mortality Rate. Along with community‐based interventions, Government of India has decided to strengthen the neonatal care services in all public health facilities across the country under the Facility Based Newborn Care Initiative. In addition, the government is working in partnership with private providers by taking on the role of a payer with the introduction of public health insurance schemes in some states of the country. As the government is making huge amount of investments in increasing access to newborn care, little has been done in ensuring the quality of care delivered. Hospital-born babies in developing countries are at increased risk of neonatal infections because of poor intrapartum and postnatal infection-control practices. In view of the urgent need to improve the quality of services of Facility Based Newborn Care in India, ACCESS Health has initiated a neonatal collaborative which is based on the Institute of Healthcare Improvement's (IHI's) breakthrough series and the Model for Improvement. The initial focus of the collaborative is on decreasing Healthcare Associated Infections (HAI) and antibiotic resistance in the participating neonatal units.In the second phase, the pilot collaborative can be scaled by partnering with the public health financing schemes in the country. The backbone of any health reform would be maximum utilization of information technology for generation of data to guide the policy makers in the country. The role of a payer would be critical not only for generating data for bench marking but also, to create an incentive for empanelled hospitals to utilize this information for identification of areas of need and self improvement.